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Secondary syphilis 

Secondary syphilis
Chapter:
Secondary syphilis
Author(s):

Angela Houston

DOI:
10.1093/med/9780199665754.003.0004
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date: 19 January 2020

Over the past 10 years syphilis has once again become endemic in the UK with highest rates in those with HIV and men who have sex with men (MSM). Primary syphilis should be considered as part of the differential diagnosis in all individuals with mouth or anogenital ulceration, and secondary syphilis should be considered in all those with rash and constitutional symptoms. A case of meningovascular syphilis is presented here and exemplifies how neurosyphilis should be considered in patients with a wide range of neurological presentations. The key to managing syphilis is considering the diagnosis in the first place. Screening for syphilis is easy and cheap using the new IgG/IgM and this test is always positive in patients with syphilis, apart from the rare individuals with incubating or very early primary infection who are unlikely to be seen in general medical settings.

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